Apanemia Health Centre

Patients with lumbago ask x-rays, some doctors opt for physical therapy and others, schools back. Although back pain is one of the most common problems are many uncertainties about what are the best tools to diagnose and treat.

Physical Exam
85% of lower back pain can not be attributed to a particular disease or abnormality (so-called non-specific back pain). When the query reaches a patient with low back pain, it is advisable to perform a history and physical examination to determine if the pain is nonspecific causes or could be a serious problem, like a cancer, a fracture or a herniated disk. “No evidence suggests that labeling most patients with low back pain using specific diagnostic tools to improve results,” say the authors, who do recommend, however, study or social psychological factors (depression, job dissatisfaction …) that could delay recovery.

The Usefulness of Drugs
Drugs are an effective short-term therapy, but always combined with information and self care. Paracetamol and anti-inflammatories (like ibuprofen or naproxen) are good choices in most of those affected, so are the drugs of first choice. The authors do not bet on a particular product: each has advantages and disadvantages (paracetamol is less powerful, but with less side effects), so his choice will depend on each patient. Also, the tricyclic antidepressants (chronic back pain) and muscle relaxants (acute pain) have been shown to relieve pain in the short term.

Alternative Therapies
If you do not work or information, or self-care, not drugs, it is time to use nonpharmacological strategies. Although the work has evaluated these 17 therapies, only some are effective. In acute cases (less than four weeks), the only thing that spinal manipulation is either chiropractic or other technique, but the benefits are modest.

When the pain lasts between one and two months (subacute), the review advocates a multidisciplinary rehabilitation (medical consultation, physical therapy, psychological …). Finally, when pain becomes chronic (more than eight weeks), there are several therapies that have proved useful: acupuncture, exercise, massage, behavioral therapy, relaxation, spinal manipulation and rehabilitation disciplines. As its efficacy is similar, the choice of either strategy depends on patient preferences, cost, convenience and availability of a trained therapist.

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